Application Form for Admission to Class XI

Form No. :

ULTIMATE COLLEGE

Teddim Road, Bijang, Churachandpur, Manipur

APPLICATION FORM FOR ADMISSION TO CLASS XI

Session 2026-27

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All fields are required unless marked Optional or (if any) — including the passport photo. You can only submit once every required field is filled.

Letterhead & Photo

Admission Sought

Stream to which admission is sought *

Arts Science

Personal Details

3. Name (in block letters, as recorded in HSLC) *

4. Date of Birth (as per HSLC) *

5. Gender *

Male Female

6. Aadhaar Number *

7. UDISE Permanent Education Number (PEN) *

8. UDISE APAAR ID *

Parent / Guardian

9. Name of Mother (as per HSLC) *

Mother — Occupation *

10. Name of Father (as per HSLC) *

Father — Occupation *

Address & Contact

11. Permanent Address *

PIN *

12. Current Address

13. Primary Contact Number (cannot be the applicant's number) *

Mother Father Any Other

14. Personal Contact No. (if any)

15. WhatsApp Number

Previous School & Qualifying Examination

Name of Last School Attended *

School Address *

Last School is affiliated to *

CBSE ICSE State Board

Result of Qualifying Examination *

Exam Passed	Roll No.	Name of the Board	Year of Passing	CGPA	Percentage	Division

Note: take into account only the marks in the subjects counted for awarding class or division.

Declaration

DECLARATION OF THE APPLICANT

By my signature below, I hereby acknowledge and confirm that I have carefully read and understood the stated policy of ULTIMATE COLLEGE and undertake the following:

I hereby declare that the entries made and the documents submitted in support of the information provided in the Application Form are complete and true in all respects to the best of my knowledge and based on available records.
I understand that 90% attendance in classes is compulsory, and I commit to adhering to this requirement. I also understand that if my attendance falls short for any reason, the competent authority of the Institute may take any punitive action against me that it deems fit and proper.
If admitted, I shall abide by the rules and regulations of the Institute and obediently follow the instructions of my mentors as given to me from time to time.

Date *

Place *

Signature of Student

Signature of Parent/Guardian

Relation with student *

Notes

Change of subject(s)/stream for Class XI will be allowed within three weeks from the date of admission, with prior permission from the Principal.
List of documents to be enclosed:
1. Two Xerox copies of HSLC Provisional Certificate
2. Two Xerox copies of HSLC Admit Card
3. Two Xerox copies of HSLC Mark Sheet
4. Two Xerox copies of Transfer Certificate
5. Two Xerox copies of Tribe Certificate
6. Two Xerox copies of Income Certificate
7. One Xerox copies of Aadhaar Card (or Voter ID Card)
8. Two recent passport size photo
9. Eligibility Certificate from Council of Higher Secondary Education, Manipur for those students who come from boards other than Board of Secondary Education, Manipur.
A mark sheet downloaded from the internet may be accepted as provisional at the time of admission.
The Permanent Education Number (PEN) may be obtained from the previous school attended.
All original documents must be produced at the time of admission.

Science

Science — Optional

Arts (MIL: Gangte, Paite, Thadou Kuki, Vaiphei, Zou)

Arts — Optional